ABUJA — While most of the world sees polio as a thing of the past, the disease appears to be on the rise in Nigeria. The Council on Foreign Relations, a U.S.-based think tank, says the Boko Haram insurgency in Nigeria’s north is part of the problem and securing the area has to be part of the solution.

The Global Polio Eradication Initiative says Nigeria has 77 new cases of polio this year so far - a near 25 percent increase compared to all of last year. And that's more than any other single country.

There is no cure for polio, but the disease can be prevented with a vaccine and it has been wiped out in most of the world. If a person is infected with polio, it can lead to paralysis, disfigurement or death. On the streets in Nigeria, survivors can be seen begging. With useless legs they sit on boards with wheels. They have to reach up to passersbys to ask for a little money.

John Campbell, a senior fellow at the Council on Foreign Relations and a former U.S. ambassador to Nigeria, says the vaccine is available in northern Nigeria, where most of the victims are found, but families often refuse it. He says many think it is a plot against Muslims devised by southern Christians and the West.

"A team administering the polio vaccine might work a street," said Campbell. "When the local residents hear the team is coming, they start handing particularly their male babies out over the back fence so they are not there when the polio workers arrive."

He says this mistrust has been aggravated by Western pharmaceutical companies in the past, whose misdeeds have caused northern governors to shut down vaccine programs from time to time.

The way to convince people the vaccine will help their children, he says, is to work through local institutions, like schools or mosques.

“We’re talking about a real issue that can best be addressed using indigenous and local structures," said Campbell. "But the indigenous and local structures are in many cases under assault, or at least under stress from Boko Haram.”

The militant group known popularly as Boko Haram has been blamed for over 1,000 deaths since 2009. Most of the attacks have been in the north, but the group has also conducted bombings in the capital, including a media house and the local United Nations headquarters.

Dr. Jibrin Ibrahim, the director of the Center for Democracy and Development in the Abuja, says ending the violence is largely dependent on negotiations, which the government says are in their beginning stages. But, Ibrahim says, Boko Haram is secretive, and it is hard to tell if the talks are making progress.

"Nobody has actually spoken formally to these people so you don’t know their organizational structure," said Ibrahim. "So even the statement that they are fractured may be a conjecture. It may be true. It may be false. But we do know from what they themselves say that sometimes people that do not belong to them speak on their behalf."

Campbell says insecurity in the north also makes it hard for aid groups to start new vaccine programs and the Boko Haram's ideology, which is deeply distrustful of the West, reinforces the fear of vaccines.

The World Health Organization says polio cases have decreased by over 99 percent since 1988, from an estimated 350,000 victims. Pakistan, Afghanistan and Chad are the only other countries besides Nigeria that have reported new cases this year.